血流导向装置释放前后动脉瘤腔内的压力变化  

Pressure Changes within the Aneurysmal Sac Before and After PED Deployment

作　　者：钟建国 邱传珍 刘明 黄小玉 杨少春 ZHONG Jianguo;QIU Chuanzhen;LIU Ming(The First Clinical Medical College of Gannan Medical University,Ganzhou,Jiangxi Province 341000,P.R.China)

机构地区：[1]赣南医科大学第一临床医学院,赣州341000 [2]赣南医科大学神经外科,赣州341000 [3]赣南医科大学护理学院,赣州341000

出　　处：《临床放射学杂志》2025年第5期826-831,共6页Journal of Clinical Radiology

基　　金：赣州市科技局重点研发项目(编号:2023LNS37753)。

摘　　要：目的探讨在治疗未破裂的颅内动脉瘤时,释放血流导向装置(PED)前后动脉瘤腔内压力的变化。方法术中,Echelon 10微导管与压力传感器相连,并被放置在动脉瘤腔内。在释放PED前后测量动脉瘤腔内的压力,同时测量平均动脉压(MAP)。比较释放PED前后瘤腔内压力变化以及瘤腔内压力[如瘤内收缩压(ISP)、瘤内舒张压(IDP)及瘤内平均压力(IAP)]与全身动脉血压的比值。结果共纳入23例患者,平均年龄为59.78岁。在整个队列中,ISP在治疗后显著降低(76.00 mmHg vs.67.00 mmHg,P=0.037)。PED释放前后的IAP/MAP分别为0.90±0.16和0.85±0.16,IAP/MAP显著低于PED释放前,差异具有统计学意义(t=2.541,P=0.019)。结论在使用PED治疗未破裂颅内动脉瘤(UIA)的过程中,PED置入后动脉瘤腔的压力以及IAP/MAP比值均呈现出明显的降低趋势。这一发现可能揭示了PED置入对血流动力学产生的深远影响。未来需要在更大的样本量中进一步验证这些压力变化,以期为颅内动脉瘤的血管内治疗提供更加精准的指导和依据。Objective The Pipeline Embolization Device(PED)is frequently utilized in endovascular interventions for intracranial aneurysms,yet the impact of PED deployment on aneurysmal sac pressure remains largely unknown.This study endeavors to explore the variations in aneurysmal sac pressure before and after PED deployment in the context of treating unruptured intracranial aneurysms(UIAs).Methods During the surgical procedure,an Echelon 10 microcatheter,linked to a pressure sensor,was positioned inside the aneurysmal sac.Pressures within the aneurysmal sac,as well as the mean arterial pressure(MAP),were measured both before and after PED deployment.Comparisons were conducted to assess changes in aneurysmal sac pressure and the ratio of intra-aneurysmal pressure(IAP)to MAP before and after the procedure.Results This study enrolled a total of 23 patients with a mean age of 59.78 years.Across the study population,a statistically significant decrease in intra-aneurysmal systolic pressure was observed post-treatment(76.00 mmHg vs.67.00 mmHg,P=0.037).The IAP/MAP ratios prior to and following PED deployment were 0.90(±0.16)and 0.85(±0.16),respectively,with the post-deployment ratio being significantly lower(t=2.541,P=0.019).Conclusion In the treatment of UIAs using PED,a notable reduction in aneurysmal sac pressure and IAP/MAP ratio is observed after PED deployment.This reduction may be attributed to hemodynamic alterations induced by the PED.These pressure dynamics merit further investigation in a larger patient cohort to provide more precise guidance for the endovascular treatment of intracranial aneurysms.

关 键 词：PED 颅内未破裂动脉瘤 延迟性破裂 压力变化 血流动力学 

分 类 号：R651.1[医药卫生—外科学]